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Time to sign up for insurance

Online marketplace slated to open Oct. 1 amid confusion

By AP Medical Writer CARLA K. JOHNSON (AP)

Sept. 23, 2013

AP Photo/Sun-Times Media, Al Podgorski

Caption

In this Feb. 13, 2013 file photo, Illinois Gov. Pat Quinn looks on as U.S. Health and Human Services Secretary Kathleen Sebelius speaks at a news conference in Chicago. Sebelius was there to announce that Illinois has received conditional federal approval for its plan to help run an online marketplace where thousands of state residents can shop for health insurance beginning Oct. 1.

CHICAGO (AP) – For many Illinois residents, it’s time to take a deep breath and get ready to shop for health insurance. President Barack Obama’s health care law requires nearly every American to have insurance starting in 2014. To make shopping for coverage easier, a new online marketplace is set to open Oct. 1.

The buildup to next week’s launch in Illinois has been fraught with uncertainty as federal and state officials keep tight control of information. They haven’t revealed the prices of the insurance plans to be offered on the new marketplace, perhaps to avoid tipping off insurance carriers who are opting not to participate this time.

Consumers still don’t know which companies will offer health coverage and whether the insurance policies will offer a wide or narrow choice of hospitals and doctors. Outreach workers who will help people navigate the new marketplace are still wrapping up their training.

The pricing information may be made public before Oct. 1 and there may be some announcement of an Illinois website that will be the first stop for consumers. For now, that’s still a mystery along with the $35 million ad campaign that Illinois has commissioned to promote the marketplace.

Though signed into law by Obama in March 2010, the controversy over the law has not abated. In Washington, House Republicans passed a stopgap funding bill that would shut down the government unless funding is stripped from the health law they call “Obamacare” and consider big government. Senate Democratic leaders have vowed to protect the law, but it’s likely the headlines are adding to consumer confusion.

Much work is left to demystify the Affordable Care Act and how it will affect Illinois residents. Here is some of what you need to know:

Q. What’s the big deal about Oct. 1?

A. It’s the first day of the open enrollment period for new health insurance options under the health law. Consumers have until Dec. 15 to sign up if they want coverage to start Jan. 1. After that, you can still enroll through the end of March to avoid penalties for 2014. The law requires almost everyone to have health insurance. Fines start as low as $95 the first year but go up after that.

Oct. 1 is the first day people can start shopping for health insurance on a new marketplace where they can get financial help with the cost. To get started, go to healthcare.gov.

Q. How many people are uninsured in Illinois?

A. About 1.8 million Illinois residents are uninsured, about 15 percent of the population.

Q. Who should shop for health insurance on the new online marketplace?

A. The marketplace is meant for people who can’t afford health insurance right now and for people who want to comparison shop for insurance. The website will tell you whether you qualify for new federal tax credits to help pay the cost of coverage. It also will tell you whether you’re eligible for free care through Medicaid or if your children are eligible for the Children’s Health Insurance Program.

Q. Who is left out?

A. About 281,000 people in Illinois who are in the United States illegally aren’t eligible for help under the new health law.

Q. If I already have affordable health insurance through my job, why should I care?

A. If more people get insurance, fewer medical costs will be shifted onto people with good health insurance by hospitals and other providers that end up providing free care to the uninsured.

Q. Will insurance coverage cost more or less than what’s available today?

A. That’s hard to say because Illinois hasn’t published the prices yet. We do know that the law requires certain benefits, so health plans will be more comprehensive and probably more expensive than the ones some people now buy. But the tax credits will help bring down costs for most low- and middle-income people. People who have pre-existing medical conditions won’t have to pay higher premiums than healthy people. Insurers will be prohibited from charging women higher prices.

Q. Do I have to buy health insurance on the new marketplace?

A. About half of Illinois residents already have coverage through their jobs and their employers pay a portion of their premiums. They don’t have to buy new insurance. In fact, if your insurance is affordable and meets certain federal criteria, you won’t qualify for tax credits on the marketplace.

People already insured under Medicare or Medicaid don’t have to do anything new. Veterans who are enrolled in Veterans Affairs health care don’t have to buy additional insurance. U.S. citizens living abroad aren’t required to get coverage.

Q. Where can I get information and help?

A. County health departments, community health centers and libraries can answer questions and help you get started. Many community organizations have trained outreach counselors who can walk you through the enrollment process. Insurance agents and brokers also can help.

The federal government has a call center taking questions at 1-800-318-2596.